Daily Symptom Tracker After a Hysterectomy

Was the pain worse last week or the week before? When did the night sweats start? After a few weeks, it's hard to remember.

A hysterectomy symptom tracker gives you a daily record to look back on, during your recovery and in the years after it.

Key points

• Pick the symptoms you want to watch and rate each one from 1 to 5 every evening.
• On bad days, a quick check-in takes one tap.
• After two weeks, the tracker shows which symptoms are better or worse.
• The Doctor summary lists what changed, your hardest days, and three symptoms to bring up first.
• The tracker is only a record. If you have any of the get-help signs, stop logging and get help.

How do I use the symptom tracker?

Pick your symptoms once, then rate them each evening. Your answers save as you tap.

Setting it up

1. Add your surgery date. This is optional. For example, with a date, each day shows as "Day 18, week 3 after surgery".
2. Check what's ticked. If your surgery was under eight weeks ago, five common symptoms are already ticked: pain at the incisions or scar, bleeding or spotting, constipation or painful bowel movements, fatigue that stops you mid-day, and feeling down.
3. Change the list. Untick what you don't need and tick what you do.
4. Add your own. You can add up to three symptoms in your own words.
5. Tap Start tracking.

You can change your list any time under Settings and backup.

Your evening check-in

Rate each symptom from 1 (mild) to 5 (severe), going by how it was today.

Tap None if it wasn't a problem today. If you leave a symptom blank, it shows as "Not filled in" and doesn't count toward your average.

The last question is "Overall, how hard was today?" You'll also see how today compares with the day before.

To change a rating, tap a different number. To clear it, tap the same number again. To go back to an earlier day, use the arrows beside the date, or tap that day's square in Progress.

Add more about today is optional. It asks about your sleep, your activity, and anything that happened that day, and it has space for a note. The tracker uses your sleep and activity answers for "What seems to make it worse".

To get a reminder, go to Settings and backup, pick a time, and tap Add to my calendar.

On bad days

Switch to Quick check-in. It asks one question, how hard today was, and takes one tap. The tracker stays on quick until you switch back.

Quick check-ins fill in your month view, but they don't rate each symptom, so those days won't count toward its average.

What symptoms should I track after a hysterectomy?

Track anything you want to keep an eye on or tell your doctor about. What you pick will depend on how long it's been since surgery and whether your ovaries were removed.

In the first eight weeks

Keep the five already ticked and add anything else that's bothering you, such as pelvic pain, discharge, swelling or dizziness.

Keep fatigue on your list, because it often outlasts the pain. Mood is useful to track too. Feeling emotional is common after surgery. If you still don't feel like yourself after a few weeks, show your doctor your ratings.

If your ovaries were removed

If both ovaries were removed, menopause started the day of surgery, at any age. It often comes on harder than natural menopause. Surgical menopause symptoms to track include:

• Hot flashes and night sweats
• Waking during the night, or waking up exhausted
• Brain fog or memory lapses
• Mood swings, anxiety or irritability
• Joint or muscle aches
• Vaginal dryness, or changes in your sex drive

If you kept your ovaries

Your ovaries can still stop working early. In a 2011 study by Moorman and colleagues, women who'd had a hysterectomy and kept their ovaries were nearly twice as likely as women who hadn't had the surgery to have them stop working within four years. The researchers couldn't say whether the cause was the surgery or the condition that led to it.

You no longer have periods, so they can't tell you when menopause starts. Over 45, menopause after a hysterectomy is usually identified by your hormone symptoms, with no blood test needed. If you have hot flashes, night sweats or trouble sleeping, add them to your list.

If you're not sure what was removed, find out which path you're on.

Things that aren't on the list

Use the Your own boxes for anything else, such as shoulder pain, restless legs or tingling. Write it the way you'd say it.

To record something that happened once, use the "Something else" box under "Anything happen today?"

How long should I track my symptoms?

Track for at least two weeks, because that's when the first week-to-week comparison appears. After that, keep going for as long as you find it useful.

You don't need a perfect log before you see your doctor. Bring what you have, even if it's only a week. The summary shows how many days you logged.

If you're starting, changing or stopping HRT:

1. Log for a week or two before the change, if you can, so you have something to compare with.
2. Mark the day. Under "Anything happen today?", tap Started HRT, Changed HRT dose, or Stopped HRT. A ◆ appears on your progress view.
3. Keep logging until your review. Symptoms should improve within days or weeks, but the full effect can take up to three months. Your first review is usually about three months after you start or change the type you take.

What does the progress view show?

Progress shows how each symptom compares with last week, your ratings day by day, and what seems to make your symptoms worse.

Since last week

Each symptom shows Better, Worse or About the same, plus its usual rating this week. The tracker needs three logged evenings in both weeks to compare them. Until then, you'll see "Not enough days".

Day by day and month

Day by day is a grid of your symptoms across the week. The darker the square, the worse that day was. Tap a square to open that day. A ◆ marks a change, such as starting HRT or going back to work.

Month is a calendar showing how hard each day was overall.

You can print either view.

What seems to make it worse

The tracker looks for things that tend to go along with higher ratings. For example, it might say, "On your busier days, you tend to rate pain at the incisions or scar higher."

To show anything, it needs your answers from Add more about today, with at least three days that have the factor and three that don't. Each day is compared with the days around it, so normal healing doesn't show up as a pattern.

It shows what tends to happen together, which doesn't prove one thing causes the other.

It also only compares ratings from the same day. Overdoing it often shows up hours later or the next morning, so use your note for anything that happens the day after.

How do I use it at my doctor's appointment?

Open Doctor summary, choose your dates, then print it or copy it.

1. Pick your dates. Choose Last 2 weeks, Last 4 weeks, or Since surgery. If you didn't add a surgery date, the last button says Everything.
2. Check "Three to bring up first". The tracker picks anything getting worse, then whatever has been worst. If the symptom bothering you most isn't there, bring that one up first.
3. Choose whether to include your notes. They're left out unless you tick Include my notes.
4. Print or copy it. Tap Print summary, or tap Copy as text to paste it into an email or patient portal message.

The summary shows your dates, how many days you logged, and each symptom's average, worst rating and number of bad days. It also lists your hardest days, any changes you marked, and how many days you needed pain medication. A line at the bottom of the printout says you filled it in yourself and that it isn't a diagnosis.

To prepare for the appointment, tap Build my question list. It opens the questions to ask your doctor, with the topics from your summary ready.

When should I call instead of tracking?

Get help right away if you have any of the get-help signs. The tracker can't tell you what a symptom means.

Signs to get help now is at the top of every tab. Tap it to open the list.

Check these signs appears when your ratings are high, usually a 4 or 5 on symptoms like bleeding, pelvic pain or pain around a cut. Bowels and swelling need three days running at 4 or more, since one bad day is common. In your first two weeks, other symptoms need ratings that rise three days running.

If that panel doesn't appear, it doesn't mean everything is fine. The tracker only knows your ratings, so it can't pick up a fever or a change in discharge. See the full list of when to call your doctor, and follow the instructions your own hospital gave you.

If something frightens you and it isn't listed, call anyway.

Where is my information saved?

Your information is saved in the browser you're using, on your device. It's never stored on the site, so it can't be recovered if it's deleted.

• Keep a backup. Clearing your browsing data erases your log. Under Settings and backup, tap Download a backup from time to time.
• Moving to a new phone or computer: download a backup on the old one, then tap Load a backup on the new one.
• On an iPhone, use a home screen icon. Safari can erase saved data from a site you haven't tapped on for seven days. A home screen icon is exempt, but it keeps a separate log from Safari, so add it before your first entry. If you've already started in Safari, move your log with a backup.
• On a shared device: anyone who opens the tracker in that browser can see your log.
• Avoid private browsing. A private window can erase your log when you close it.
• To delete your log: under Start over, tap Delete everything. This can't be undone.